Tuesday, November 01, 2016

We have assisted suicide in Canada now but all kinds of ethical problems are cropping up

Adam Maier-Clayton lives in constant pain and wants to die. The 27-year-old business school graduate has battled anxiety, mood disorder and obsessive compulsive disorder since he was a child.
He says his debilitating pain feels like parts of his body are being burned by acid. Despite a host of treatments, some of them experimental, his agony has only worsened in recent years. Fed up with the torment, Maier-Clayton wants doctors to help him end his life. But Canada's assisted dying laws, which came into effect last summer, do not apply to people with mental illness.
Maier-Clayton says the pain is constant, but it worsens with any kind of cognitive activity, including reading and speaking.
"I can't get through three pages of a book," he said. "Just to get through the first two would leave me with six hours of pain. I can't read, I can't write."
Doctors have not been able to determine the physical cause of his pain, so they believe it must be linked to his mental conditions. Maier-Clayton has tried a variety of medications, including antidepressant and anticonvulsant drugs. He's also had extensive therapy and counselling. Most recently, he has tried the experimental ketamine infusion therapy. Nothing has helped.Quality of life
After graduating with honors in business from Algonquin College, Maier-Clayton left Ottawa and moved home to Windsor to live with his dad. The pain was just too much, and he needed help. Graham Clayton will often use hand signals and gestures to communicate with his son, just to reduce the amount of time he spends talking.
"It's hard. I raised my son pretty much by myself," said Clayton. "You keep hoping the doctors will find something, come up with something. There's hope after hope, then your hopes are dashed."
Because both Maier-Clayton and his dad see no other solution, they want the federal government to legalize doctor-assisted dying for those with mental illness.
"Non-existence is better than this. Non-existence is better than having my father go down my banking history to make sure everything is in check," he said. "The real reason for someone like me wanting the right to die is simple: Once there's no quality of life, life is akin to a meaningless existence."
Maier-Clayton said the current law does not protect people like him.
"If someone is suffering for years and years like myself, then what are you protecting them from?" he said. "You're not protecting them. You're condemning them to pain."
'An awful sentence'
Experts are divided when it comes to opinions about whether assisted dying legislation should include people will mental illness. Jean Echlin, a nurse consultant in palliative care and gerontology, says there isn't enough medical and community support in place for the mentally ill.
"I think people are very worried we're going to make some bad mistakes and take lives away when we haven't done the appropriate research in psychiatry and mental illness," said Echlin, who is also an adjunct associate professor at the University of Windsor and president of the Euthanasia Prevention Coalition.
"If somebody takes their life now, they're dead for keeps, but if two weeks from now there's a breakthrough, then they've lost their life when they could have had more quality time."
Ellen Wiebe, a clinical professor at the University of British Columbia, has a tough time with Maier-Clayton's case. While the doctor has helped 33 people die, and is the only doctor in Canada to oversee the death of a psychiatric case, she acknowledges he's young.
"I don't think I could do it for someone in their 20s," she said. "I would have too much trouble with someone younger than my own kids."
Generally, though, Wiebe said she'll follow the law, but wants a provision in the legislation to include the mentally ill.
"Psychiatric patients should not be discriminated against," she said. "They should be allowed to have their suffering and pain recognized as grievous and irremediable. Why should we condemn them to everlasting suffering? That is being consciously cruel."'Incredibly surreal'
Maier-Clayton continues to push for his cause, through Youtube videos and written posts on social media. He acknowledges his illnesses are worsening and does not know how much longer he can fight.
"It's incredibly surreal," he said. "At this point in my life, I always thought I'd be on Bay Street or trying to get to Singapore to live in a commerce hub. I personally love life. I don't want to leave. If I could snap my fingers and all these illnesses could be cured, we wouldn't be sitting here today."
The government says the current law protects people with mental illness, but Maier-Clayton disagrees. If the law does not change anytime soon, he says he's considering taking his own life.
"I'm a lot closer than I'd like to be. I'm relatively close," he said. "I don't self harm, I've never cut myself, I've never had a suicide attempt. But I know as every day passes, I've had more and more of enough."
His dad understands that.
"I don't want it but I can't change it," said Clayton. " I can't say the words he wants to hear and may never be able to. One morning he'll just be gone. Hope as I might, I think it might be inevitable and I can't change that."